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Contact Information

CHADDOCK
921 N 24TH ST
QUINCY, IL62301-2267
 Phone: 217-222-0034
 Fax: 217-222-0253
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foster Care Agency

253J00000X
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
Indicates primary specialty

NPI Profile & details for CHADDOCK

NPI Number 1093063208
LBN Legal business name CHADDOCK
Authorized official KRISTEN PATTON - (DIRECTOR OF FINANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 08/17/2012
Last updated 09/25/2023 - About 3 years ago
Identifiers
IL License # 004048-12
IL Medicaid #3A00-IPI-019
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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